What is Carotid Angioplasty and Stenting?
Carotid angioplasty is a non-surgical procedure performed after the diagnostic angiogram. The carotid angioplasty procedure can be performed the same day as the diagnostic angiogram or days or weeks after the angiogram.
During angioplasty, a balloon catheter is guided to the area of the blockage or narrowing. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls to improve blood flow.
During the angioplasty procedure, a carotid stent (a small, metal mesh tube) is placed inside the carotid artery at the site of the blockage and provides support to keep the artery open.
For patients who meet certain eligibility criteria, carotid stenting offers a less invasive approach than carotid endarterectomy, the traditional surgical treatment for carotid artery blockages. Carotid stenting can be performed while the patient is awake, reducing recovery time.
What happens during the Carotid Angioplasty and Stenting procedure?
A specially designed guide wire with a filter is placed by Dr. Agusto Villa beyond the site of the narrowing or blockage in the carotid artery. Once the filter is in place, a small balloon catheter is guided to the area of the blockage. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow. The balloon is removed and the stent is placed inside the artery to widen the opening and support the artery wall.
After the stent is placed, an angiogram is performed to confirm that the stent has completely expanded and the narrowing or blockage has been corrected. Often, a second balloon catheter is inflated to ensure the stent is maximally opened. The stent stays in place permanently and acts as a scaffold to support the artery and keep it open. After several weeks, the artery heals around the stent.
Will the patient be awake during the Carotid Angioplasty and Stenting procedure?
Yes, the patient will awake and conscious during the entire procedure. Dr. Villa will use a local anesthetic to numb the catheter insertion site.
Where is the Carotid Angioplasty and Stenting procedure performed?
Dr. Villa performs the carotid angiography, angioplasty and stenting in a Hospital Cath Lab.
How long does the Carotid Angioplasty and Stenting procedure last?
The procedure usually lasts about two hours, but the preparation and recovery time add several hours. Please plan to stay all day for the procedure, and remain in the hospital overnight.
What happens after the Carotid Angioplasty and Stenting procedure?
The sheath may remain in place or a vascular plug or suture may be used to achieve hemostatsis.
You will be required to lay flat after the sheath is removed. This is necessary to prevent bleeding. You may receive medication to reduce discomfort. Dr. Villa will determine how long you will have to lay flat, which could be from 2 to 6 hours.
Plan on staying overnight in the hospital after the procedure. You will be evaluated by Dr. Villa, have a neurological exam, and have other tests, such as a carotid ultrasound, to evaluate the results of the procedure. Dr. Villa Your doctor will discuss the results of the procedure with you and your family.
Before you go home, you will be given instructions about your medications, diet, activity, and when to call your doctor.
You will need to take it easy for a few days after the procedure. You may climb stairs, but use a slower pace. Do not strain during bowel movements.
Gradually increase your activities until you reach your normal activity level by the end of the week.